Male Circumcision and Risky Sexual Behavior in Zimbabwe: Evidence from the 2010-11 Zimbabwe Demographic and Health Survey

Chikutsa, Antony; Ncube, Alfred Champion; Mutsau, Shephard

doi:10.11564/28-0-557

Cited by 6 publications

(9 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The methodology used in this study is similar to the one used in an earlier study which focused on the association between circumcision status and risky sexual behaviour [ 12 ]. The study relied on data on men between the ages of 15 and 54 years obtained from the Zimbabwe Demographic and Health Survey (ZDHS) of 2010–11.…”

Section: Methodsmentioning

confidence: 99%

“…Subsequent studies have shown a high level of knowledge of VMMC among women and men in Zimbabwe [ 6 , 9 ]. Studies on circumcision and behavioural disinhibition among circumcised men in Kenya, Malawi and Zimbabwe have also allayed fears that circumcised men engage in risky sexual behaviour [ 10 - 12 ]. However, in Uganda, it was found that circumcised men engaged in riskier sex behaviour compared to uncircumcised men although their HIV prevalence rate is lower [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Association between wanting circumcision and risky sexual behaviour in Zimbabwe: evidence from the 2010–11 Zimbabwe demographic and health survey

2015

Self Cite

View full text Add to dashboard Cite

BackgroundZimbabwe adopted voluntary medical male circumcision (VMMC) as an additional HIV prevention strategy in 2009. A number of studies have been conducted to understand the determinants of VMMC uptake but few studies have examined the characteristics of men who are willing to get circumcised or the link between wanting circumcision and risky sexual behaviour. This study investigated the relationship between wanting male circumcision and engaging in risky sex behaviours. This was based on the assumption that those who are willing to undergo circumcision are already engaging in risky sexual behaviours.Data and methodsData from men age 15–45 years who were interviewed during the 2010–11 Zimbabwe Demographic and Health Survey of 2010–11 was used. A total of 7480 men were included in the sample for this study. Logistic regression was used to assess the association between wanting circumcision and risky sexual behaviours.FindingsMen in the highest wealth tercile were significantly more likely to want circumcision compared to men in lower wealth terciles (OR = 1.36, p < 0.01). Wanting circumcision was also significantly associated with age. Men in the 25–34 age category reported wanting circumcision more (OR = 1.21, p < 0.05) while older men were significantly less likely to want circumcision (OR = 0.63, p < 0.01). Christian men and those residing in rural areas were also less likely to want circumcision (OR = 0.74, p < 0.05 and OR = 0.75, p < 0.001 respectively). The findings of this study indicate a strong association between wanting circumcision and having had risky sex (OR = 1.36, p < 0.01), having multiple partners (OR = 1.35, p < 0.01) and having paid for sex (OR = 1.42, p < 0.001) However, wanting circumcision was negatively associated with having used a condom at the last risky sex (OR = 0.76, p < 0.001).ConclusionsThe association between demand for VMMC and risky sexual behaviour need continuous monitoring. We emphasise that the promotion of VMMC for HIV prevention should not overshadow the promotion of existing methods of HIV prevention such as condoms and reduction of sexual partners.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association between wanting circumcision and risky sexual behaviour in Zimbabwe: evidence from the 2010–11 Zimbabwe demographic and health survey

2015

Self Cite

View full text Add to dashboard Cite

show abstract

“…Zimbabwe (21). They all found no significant differences in risky sexual engagement between circumcised and uncircumcised men following circumcision.…”

Section: Introductionmentioning

confidence: 90%

The Effect of Male Circumcision on Risky Sexual Behaviours of Men in Rwanda: A Comparative Analysis of RDHS 2005 and 2014/15

Nambawarr

Ntaganira²

2020

Preprint

View full text Add to dashboard Cite

Background Rapid up-take of voluntary medical male circumcision (VMMC) in countries like Rwanda that implemented it as a national HIV prevention strategy since 2008, raised a public health concern of risk compensation. Risk compensation may occur if circumcised men increase their risky sexual behaviours (RSB) because of the awareness of circumcision’s 60% protection from heterosexual HIV/STIs transmission. The aim of this study was to assess the difference in RSBs among adolescent and adult circumcised men before and after the VMMC program implementation in Rwanda Methods Data of 11,037 men aged 15-59 years from Rwanda DHS 2005 and 2014/15 were analyzed using STATA version 13.0. We estimated the prevalence of ever paid sex , extramarital sex , more than 3 total lifetime sex partners, condom use at paid sex, first sex below age 15 and most recent sex partner being casual/commercial; among circumcised and uncircumcised men and compared between surveys. Association of these behaviours with circumcision status were also determined using bivariate and multivariate logistic regression analysis in separate and in combined datasets. Results Men who reported being circumcised almost tripled from 11%(532) in 2005 to 29%(1821) in 2014/15. In all men, RSB prevalence was lower in 2014/15 than in 2005. Circumcised men were generally more likely to engage in RSB in both surveys than uncircumcised men but less likely in 2014/15 compared to 2005. Multivariate models revealed no association of circumcision with sex below 15 years in 2005 (AOR 0.89; CI: 0.65-1.19; P>0.05) and 63% protection in 2014/15 (AOR 0.63; CI: 0.51-0.76; P<0.01). In all men, while there were too few responses to determine a true difference in non-condom use , other RSB were significantly less likely whereas paid sex was significantly more likely in 2014/15 due to an increase among the uncircumcised (AOR 1.29; CI: 1.03-1.61). Conclusion The findings did not support risk compensation. However, more responses on condom use are needed to check its disinhibition among circumcised men. Ongoing VMMC campaigns should re-inforce pre-counseling to young men 15-24 in the provinces out of Kigali to delay sexual debut even after circumcision.

show abstract

“…In the era before the RCT results were known, men may thus not have changed their sexual behaviors following circumcision. Those studies that were conducted in the era after publication of the RCT results mainly used cross-sectional surveys 12 , 13 , 20 or qualitative interviews 14 , 15 and thus allowed only relatively weak inference on causal effects. One study carried out in the post-RCT era from the Rakai district of Uganda used longitudinal data to identify incident circumcision and to relate this exposure information to sexual behavior.…”

Section: Introductionmentioning

confidence: 99%

Does Incident Circumcision Lead to Risk Compensation? Evidence From a Population Cohort in KwaZulu-Natal, South Africa

Ortblad

Harling

Chimbindi

et al. 2019

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

Background Voluntary medical male circumcision reduces men’s risk of HIV acquisition and may thus increase HIV risk-related sexual behaviors through risk compensation. We analyze longitudinal data from one of Africa’s largest population cohorts using fixed effects panel estimation to measure the effect of incident circumcision on sexual behaviors. Setting KwaZulu-Natal, South Africa. Methods An open population cohort of men were followed from 2009 to 2015. Men self-reported their circumcision status and sexual behavior annually. We used linear regression models with individual-level fixed effects to measure the effect of incident circumcision on recent sex (past 12 months) and sexual behaviors that increase HIV risk (not using a condom at last sex, never using condoms with the most recent sexual partner, concurrent sexual partners at present, and multiple sexual partners in the past 12 months). We controlled for potential time-varying confounders: calendar year, age, education, and sexual debut. Results The 5,127 men in the cohort had a median age of 18 years (IQR 16 to 24) at cohort entry. Over the study period, almost one in five of these men (19.4%) became newly circumcised. Incident circumcision affected neither recent sex (percentage point change [PP] 0.0, 95%CI −1.2 to 1.3) nor sexual behaviors that increase HIV risk (PP −1.6, 95%CI −4.5 to 1.4). Conclusion The data from this study strongly reject the hypothesis that circumcision affects sexual risk taking. Risk compensation should not serve as an argument against increased and accelerated scale-up of circumcision in this and similar communities in South Africa.

show abstract

Male Circumcision and Risky Sexual Behavior in Zimbabwe: Evidence from the 2010-11 Zimbabwe Demographic and Health Survey

Abstract: In 2009, Zimbabwe adopted voluntary medical male circumcision (VMMC)

Cited by 6 publications

References 9 publications

Association between wanting circumcision and risky sexual behaviour in Zimbabwe: evidence from the 2010–11 Zimbabwe demographic and health survey

Association between wanting circumcision and risky sexual behaviour in Zimbabwe: evidence from the 2010–11 Zimbabwe demographic and health survey

The Effect of Male Circumcision on Risky Sexual Behaviours of Men in Rwanda: A Comparative Analysis of RDHS 2005 and 2014/15

Does Incident Circumcision Lead to Risk Compensation? Evidence From a Population Cohort in KwaZulu-Natal, South Africa

Contact Info

Product

Resources

About